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ObeSense

Monitoring the Consequences of Obesity

Motivations
 Obesity is associated with multiple health problems
– Cardiovascular diseases
– Atrial fibrillation
– Hypertension
– Obstructive sleep apnea
– Diabetes
– Certain types of cancer

 Has been proven to reduce life expectancy :
– 10% of premature adult deaths

 Is reaching epidemic proportions
– Ex : Switzerland : 48.7% overweight, 8.3% obese
– 7.3% of the total healthcare expenses

 Guidelines about identification, evaluation and treatment exist
– Those guidelines require long-term monitoring
– Such monitoring systems do not exist

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Objectives

 Answer a clear medical need by joining research in

physiological markers sensors with clinical end-users
– Develop innovative and non-invasive sensors
– Integrate them into single long-term monitoring systems adapted

to obese patients
• Multi-parametric, low-power, allergy-free, comfortable, with on-line feedback.

– Innovations in
• Sensors (including robustness & cost)
• Algorithms (in real-life conditions)
• Ultra-low power HW & SW design
• Integration into smart textiles
• Clinical practice

– Central involvement of end-users
• Through 3 clinical scenarios

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Clinical scenarios

 Scenario 1: physical activity & lifestyle
interventions

– Supervised by Dr O. Dériaz (IRR) and Dr U. Mäder

(SFISM) on patients following activity regimen in lab
settings and at home

 Scenario 2: hospitalization monitoring
– Obesity and atrial fibrillation, hypertension and type-2

diabetes
– Supervised by Dr E. Pruvot (CHUV)

 Scenario 3: ambulatory monitoring
– Obesity and outpatient cardiovascular complications
– Supervised by Dr E. Pruvot (CHUV)

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Technical developments & validations

 Sensors, systems and algorithms
– Respiratory rate and volume
• New optical fiber belt system (EMPA)



Water vapor permeable
Adjustable in size
is protected from external light
6 have been delivered for validation

• Dedicated exploratory platform (CSEM)
– 6 measurement channels
– Isolated DC/DC converter, certified for medical application (IEC
60601-1)
– USB battery recharger
– Approved by Swissmedic

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Technical developments & validations
 Sensors, systems and algorithms
– Respiratory rate and volume
• New optical fiber belt system (EMPA)



Water vapor permeable
Adjustable in size
is protected from external light
6 have been delivered for validation

• Dedicated exploratory platform (CSEM)
– 6 measurement channels
– Isolated DC/DC converter, certified for medical application (IEC 60601-1)
– USB battery recharger
– Approved by Swissmedic

• Validation

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Technical developments & validations

 Sensors, systems and algorithms
– Respiratory rate and volume
– Cardiac Output
• EIT (EPFL-LTS5 & CSEM) :





Better understanding of the origin of the EIT signal
3D dynamic bio-impedance model from MR data
Confirmation of the feasibility of estimating stroke volume (SV) by EIT
Evidence of the sensitivity to electrode displacement
Optimization of the EIT measurement setup
Clinical validation in preparation
• (Swissethics ID: 2015-00203)

• Systolic Volume Balance (EPFL-LHTC)
– Cardiac output estimation by processing of pressure
waveforms
– Comparison with commercial systems (Nexfin)

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Technical developments & validations

 Sensors, systems and algorithms
– Respiratory rate and volume
– Cardiac Output
– Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
• Prediction of the Anaerobic Threshold (AT) from the variability of

different measures (VT, BR, HR)
• Prediction of EE from acceleration forces and bio-potentials,
advanced classification algorithm
• NIRS oximeter (USZ) : tested in phantoms and humans, and new
Java based mobile app for cell phones and tablets

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Technical developments & validations

 Sensors, systems and algorithms
– Respiratory rate and volume
– Cardiac Output
– Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
• Prediction of the Anaerobic Threshold (AT) from the variability of

different measures (VT, BR, HR)
• Prediction of EE from acceleration forces and bio-potentials,
advanced classification algorithm
• NIRS oximeter (USZ) : tested in phantoms and humans, and new
Java based mobile app for cell phones and tablets

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Technical developments & validations

 Sensors, systems and algorithms
– Respiratory rate and volume
– Cardiac Output
– Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
• Prediction of the Anaerobic Threshold (AT) from the variability of

different measures (VT, BR, HR)
• Prediction of EE from acceleration forces and bio-potentials,
advanced classification algorithm
• NIRS oximeter (USZ) : tested in phantoms and humans, and new
Java based mobile app for cell phones and tablets

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Technical developments & validations
 Sensors, systems and algorithms
– Respiratory rate and volume
– Cardiac Output
– Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
• Prediction of the Anaerobic Threshold (AT) from the variability of different

measures (VT, BR, HR)
• Prediction of EE from acceleration forces and bio-potentials, advanced
classification algorithm
• NIRS oximeter (USZ) : tested in phantoms and humans, and new Java
based mobile app for cell phones and tablets
• New monitoring device for EE and other parameters (ECG) : CE certified
and tested

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Technical developments & validations
 Sensors, systems and algorithms
– Respiratory rate and volume
– Cardiac Output
– Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
– Blood pressure
• BP from Multi-channel Photo-Plathysmography (PPG), Electro-Cardiography (ECG),

and Impedance-Cardiography (ICG)






New datalogger
Verified on healthy volunteers
Validation protocol with the CHUV
Safety and conformity test passed
Swissmedic approval for a clinical study obtained in Oct 2015
Ethical Committee approval in December 2015
On-going clinical trial (CHUV & Inselspital)

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Technical developments & validations

 Sensors, systems and algorithms
– Respiratory rate and volume
– Cardiac Output
– Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
– Blood pressure
– Smart ECG t-shirts (EMPA)
• Small single electrode with integrated humidification pad
• Integrated and validated in smart t-shirts

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Technical developments & validations
 Sensors, systems and algorithms
– Respiratory rate and volume
– Cardiac Output
– Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
– Blood pressure
– Smart ECG t-shirts (EMPA)
– Wireless body sensor network
• Completion of the design of the CSEM platform :






Two dedicated microcontrollers
Certified 12-lead ECG frontend
3D accelerometer
Li-Polymer battery
Bluetooth & WiFi
Wireless charger Qi
ISO 13485 -> CE marking for medical devise-Polymer battery

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Technical developments & validations
 Sensors, systems and algorithms
– Respiratory rate and volume
– Cardiac Output
– Energy expenditure (CSEM, USZ, IRR, EPFL-ASPG)
– Blood pressure
– Smart ECG t-shirts (EMPA)
– Wireless body sensor network
– ECG Analysis (EPFL-ASPG)
Respiratory rate estimation from ECG
Instantaneous baroreflex estimation from BP
• PPG based instantaneous baroreflex sensitivity measurements
• Estimating physiological rhythms with a very low time-delay

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Technical developments & validations

 Sensors, systems and algorithms
– Respiratory rate and volume
– Cardiac Output
– Energy expenditure (CSEM, USZ, IRR, EPFL–


ASPG)
Blood pressure
Smart ECG t-shirts (EMPA)
Wireless body sensor network
ECG Analysis (EPFL-ASPG)

 Scientific outcomes
– 8 journal papers (IEEE, ACM, Sensors, Physiological measurement, …)
– 25 conference papers
– 8 PhD students

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Clinical scenarios

 Scenario 1: physical activity & lifestyle
interventions

– Supervised by Dr O. Dériaz (IRR) and Dr U. Mäder

(SFISM) on patients following activity regimen in lab
settings and at home

 Scenario 2: hospitalization monitoring
– Obesity and atrial fibrillation, hypertension and type-2

diabetes
– Supervised by Dr E. Pruvot (CHUV)

 Scenario 3: ambulatory monitoring
– Obesity and outpatient cardiovascular complications
– Supervised by Dr E. Pruvot (CHUV)

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Platform development versus clinical scenarios

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Scenario I : Physical activity monitoring

 Platform WES (activity tracker)
– Validation of physiological parameters with




scientific publications (MET model, walking
and running speed and distance)
Validation of ECG quality sufficient for
diagnosis (on going - to be published)
CE marking with medical safety standards
Compatible with off-the-shelf smart textiles
(Polar, Addidas, Victoria’s secret, etc.)
Ready for industrial transfer

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Scenario II : Blood pressure monitoring

 Platform BP (dedicated multisensors)

– Target medical CE marking
– Approved Swissmedic & Ethics committee
– Validation of estimated central blood pressure

against catheter measurements (on-going
clinical trials at the CHUV and at the
Inselspital)
– (Almost-)ready for industrial transfer

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Conclusions

 ObeSense contributed
– A series of methods and devices
• Leading edge scientific research
• Prototype integration
• Focus on the validation
• Several fully integrated, validated and
certified
– Several on-going clinical validation

studies
• Ethical committee approved
• On-going data collection and analysis

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